What's new in diabetes care
Introduction to diabetes
Types of diabetes
Diagnosis
Risk factors & screening

Self monitoring of glucose

• Self blood glucose monitoring
• Why do I need to monitor my own blood sugar?
• How often should blood glucose test be performed?
• Blood glucose management during illness
• Target of blood glucose control

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Self blood glucose monitoring

It gives an accurate picture of your blood glucose level at time of test when compared with urine glucose test. But be aware that the capillary fasting blood glucose value (e.g. from the finger tip) is approx. 1.0mmol/l (18mg/dl) less than the venous plasma value (blood taken from the vein). The capillary blood glucose values measured after meal are the same as venous plasma values.

There are many meters on the market, for example, Accu-Chek Advantage (Roche), Glucometer (Bayer), One Touch Ultra (LIfeScan). Each meter has its own features such as the amount of blood required, the memory storage, larger visual display, longer battery life, etc. Meter should be checked regularly to make sure it is working properly.

Why do I need to monitor my own blood sugar?

In fact, self monitoring of blood glucose can help to maintain day to day control, to detect low blood glucose, to assess control during any illness, and to provide information that can be used in the prevention of long term complications.

How often should blood glucose test be performed?

How often to check blood glucose depends on the type of diabetes, the amount and frequency of medication, and how much the patient’s blood glucose changes during the day.

Recommendation on when to do blood glucose testing is shown in the following table:

* sometimes it is important to check at about 2-3 am to see whether blood glucose is too low.

For poorly controlled or unstable diabetes, blood glucose testing should be performed at least once daily and adjust treatment accordingly. Whereas for the well controlled or stable diabetes, once or twice weekly may be adequate.

Increased testing is recommended:

1. During periods of illness, surgery or stress
2. uring pregnancy
3. hen low blood sugar is suspected
4. hen there is a change in doses of medication or taking new medication

Consider the possible reasons when your tests appear puzzling:

• A high result after a hypo (a rebound hyperglycaemia)
• llness or stress can affect your test results
• xercise can cause a low blood glucose level
• ontamination

Blood glucose management during illness

Blood glucose control may worsen rapidly during illness of any kind. When you are unwell, you should:

1. NOT stop anti-diabetes medications especially insulin
2. Continue to drink fluid, e.g. clear soups, water, weak tea, etc.
3. Try to eat normally
4. If unable to eat any food, substitute with fruit juice, soft drinks or other fluids containing glucose
5. Check glucose at least 4 times a day
6. Test urine for ketones at least twice a day

If vomiting, diarrhoea and/or drowsiness persist, consult a physician immediately

Target of blood glucose control